Providers
All 10 in NJ
VIPIN GARG, M.D.
NPI 1881662062, individual, Elizabeth, NJ, Internal Medicine, Pulmonary Disease
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 18 months, but with up to 915 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
score 51 of 100, rank 8582, $2.8M at stake
Hours billed per day
Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.
| month | what was found | hours per day, lower bound | hours per day, at price | hours per day, conservative | per working day | patients | billing organizations | codes | paid |
|---|---|---|---|---|---|---|---|---|---|
| Oct 2018 | More hours than a day holds, even counting one unit per claim line | 24.1 | 15.2 | 10.2 | 13.7 | 732 | 1 | 99204 99212 99213 99214 99215 99223 99233 99291 99406 | $41K |
| Apr 2020 | More hours than a day holds, even counting one unit per claim line | 30.3 | 25.3 | 16.9 | 23.0 | 505 | 1 | 99213 99214 99215 99223 99233 99291 99309 99310 | $44K |
| May 2020 | More hours than a day holds, even counting one unit per claim line | 25.2 | 26.4 | 17.6 | 26.0 | 500 | 1 | 99204 99213 99214 99215 99223 99233 99291 99310 | $44K |
| Sep 2020 | More hours than a day holds, even counting one unit per claim line | 24.3 | 22.7 | 15.2 | 20.7 | 787 | 1 | 99205 99213 99214 99215 99223 99233 99239 99291 99309 99310 99406 | $52K |
| Sep 2021 | More hours than a day holds, even counting one unit per claim line | 24.8 | 19.9 | 13.3 | 18.1 | 838 | 1 | 99205 99212 99213 99214 99215 99233 99291 99308 99309 99310 | $52K |
| Dec 2021 | More hours than a day holds, even counting one unit per claim line | 24.0 | 17.6 | 11.8 | 15.9 | 745 | 1 | 99205 99212 99213 99214 99215 99233 99239 99291 99309 | $47K |
| Apr 2022 | More hours than a day holds, even counting one unit per claim line | 24.0 | 16.6 | 11.1 | 15.8 | 708 | 1 | 99205 99212 99213 99214 99215 99233 99239 99291 99309 99310 | $40K |
| Sep 2022 | More hours than a day holds, even counting one unit per claim line | 24.4 | 15.1 | 10.1 | 13.7 | 709 | 1 | 99205 99212 99213 99214 99215 99233 99239 99291 99308 99309 99310 | $34K |
| Mar 2023 | More hours than a day holds, even counting one unit per claim line | 28.0 | 29.4 | 19.6 | 26.4 | 822 | 1 | 99205 99212 99213 99214 99215 99223 99233 99291 99308 99309 99310 | $54K |
| Apr 2023 | More hours than a day holds, even counting one unit per claim line | 27.0 | 24.0 | 16.0 | 24.0 | 795 | 1 | 99205 99212 99213 99214 99215 99223 99233 99239 99291 99310 99406 G0442 G0446 G0447 | $43K |
| May 2023 | More hours than a day holds, even counting one unit per claim line | 31.4 | 20.8 | 13.8 | 18.7 | 911 | 1 | 99205 99212 99213 99214 99215 99223 99233 99239 99291 99309 99310 | $45K |
| Jun 2023 | More hours than a day holds, even counting one unit per claim line | 30.6 | 24.4 | 16.2 | 22.2 | 915 | 1 | 99205 99212 99213 99214 99215 99223 99233 99239 99291 99307 99309 99310 | $47K |
| Jul 2023 | More hours than a day holds, even counting one unit per claim line | 24.7 | 16.2 | 10.8 | 15.9 | 750 | 1 | 99205 99212 99213 99214 99215 99223 99233 99307 99309 99310 | $32K |
| Aug 2023 | More hours than a day holds, even counting one unit per claim line | 25.7 | 14.7 | 9.8 | 13.2 | 820 | 1 | 99205 99212 99213 99214 99215 99223 99233 99239 99291 99310 | $34K |
| Oct 2023 | More hours than a day holds, even counting one unit per claim line | 28.1 | 18.1 | 12.0 | 17.0 | 870 | 1 | 99205 99212 99213 99214 99215 99223 99233 99239 99291 99307 99308 99310 | $43K |
| Nov 2023 | More hours than a day holds, even counting one unit per claim line | 28.8 | 23.0 | 15.3 | 20.9 | 786 | 1 | 99205 99212 99213 99214 99215 99223 99233 99239 99291 99307 99309 99406 | $40K |
| Dec 2023 | More hours than a day holds, even counting one unit per claim line | 30.6 | 23.1 | 15.4 | 22.7 | 773 | 1 | 99205 99213 99214 99215 99223 99233 99239 99291 99306 99309 99310 99406 | $40K |
| Mar 2024 | More hours than a day holds, even counting one unit per claim line | 25.9 | 13.7 | 9.1 | 13.5 | 868 | 1 | 99205 99212 99213 99214 99215 99223 99233 99239 99291 99310 99406 | $37K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | VIPIN GARG, M.D. |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | March 14, 2006, last updated October 1, 2015 |
| Practice location | 240 WILLIAMSON ST, SUITE NUMBER 300, Elizabeth, NJ 07202-3674, 908-994-8880 |
| Specialties | Internal Medicine, Pulmonary Disease (207RP1001X, primary, license MA70132 NJ) Internal Medicine, Critical Care Medicine (207RC0200X, license MA70132 NJ) Internal Medicine (207R00000X, license 25MA07013200 NJ) Internal Medicine, Sleep Medicine (207RS0012X, license 220328 NY) Internal Medicine, Sleep Medicine (207RS0012X, license MA70132 NJ) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or morehistory of abuse | $998K | 25% | $54 | $88 (top 5% from $210) | 22nd percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $520K | 13% | $34 | $44 (top 5% from $110) | 34th percentile | |
| 99291 | Critical care, first 30-74 minutes | $511K | 13% | $217 | $175 (top 5% from $536) | 63rd percentile | |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $349K | 9% | $90 | $96 (top 5% from $249) | 46th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $283K | 7% | $39 | $60 (top 5% from $133) | 24th percentile | |
| 94060 | Test to measure expiratory airflow and volume changes before and after medication administration | $199K | 5% | $26 | $27 (top 5% from $143) | 47th percentile | |
| 95806 | Sleep study including heart rate, breathing, airflow, and effort | $190K | 5% | $92 | $76 (top 5% from $432) | 60th percentile | |
| 94660 | Therapy procedure using a positive pressure ventilator | $115K | 3% | $18 | $39 (top 5% from $439) | 31st percentile |
Medicare Part B 2024, largest codes
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99291 | Critical care, first 30-74 minutes | 1,832 | 106 | $324K | $500 | $223 | 2.2x | 4.7x (90th percentile 10.0x) |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 1,657 | 141 | $165K | $200 | $125 | 1.6x | 2.6x (90th percentile 4.7x) |
| 99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | 749 | 267 | $116K | $265 | $196 | 1.4x | 2.4x (90th percentile 4.1x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 832 | 307 | $64K | $120 | $99 | 1.2x | 2.2x (90th percentile 3.8x) |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 264 | 76 | $34K | $179 | $163 | 1.1x | 2.0x (90th percentile 3.4x) |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | 445 | 57 | $28K | $100 | $80 | 1.2x | 2.0x (90th percentile 3.4x) |
| 94660 | Therapy procedure using a positive pressure ventilator | 376 | 145 | $21K | $150 | $71 | 2.1x | 2.5x (90th percentile 4.5x) |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 192 | 126 | $21K | $208 | $139 | 1.5x | 2.3x (90th percentile 3.8x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
10 providers in Union County, NJ carry an indicator in the public record, with $16.0M at stake between them. The most common is more hours than a day holds, on 7 of them, followed by paid after a public list action on 2. 3 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | STUART RICE Summit, NJ, ranked 296 | $9K |
|
| 1 | STEVEN BROWNSTEIN Springfield, NJ, ranked 435 | $199 |
|
| 1 | ELITE PHARMACY, INC Linden, NJ, ranked 588 | $0 |
|
| 4 | EDGARDO TAN Elizabeth, NJ, ranked 7312 | $1.7M |
|
| 4 | TREVOR FORBES Springfield, NJ, ranked 7459 | $4.8M |
|
| 4 | IROKA IFEGWU Union, NJ, ranked 7672 | $2.1M |
|
| 4 | FEHINTOLA OGUNSAKIN Elizabeth, NJ, ranked 7700 | $1.9M |
|
| 4 | KAMRAN TASHAROFI Garwood, NJ, ranked 8571 | $2.9M |
|
Recent enforcement in NJ
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJIndictedJul 29, 2026
Fraud Division Resolves Fraud Investigation of Eye Care Group Under New Corporate Enforcement Policy; Health Care Executive Charged for Alleged Fraud and Kickbacks
DiDonato allegedly conspired to defraud Medicare by billing for unnecessary and duplicative diagnostic eye tests and paid kickbacks and bribes to ophthalmologists disguised as consulting fees for patient referrals, while Campus Eye received a declination after self-disclosing and agreed to pay back $1 million to victims.
DOJIndictedJul 29, 2026
Founder And Former CEO of New Jersey Based Eye Care Group Charged with Health Care Fraud Conspiracy and Paying Illegal Kickbacks
DiDonato allegedly paid kickbacks disguised as consulting fees to ophthalmologists for patient referrals and billed Medicare approximately $3.4 million for duplicative or unnecessary diagnostic tests performed at his optometry practice and eye surgery center.
DOJChargedJul 9, 2026
Six Individuals, Including a Pharmacist and Doctor, Charged in Connection with $20 Million Healthcare Fraud and Kickback Scheme
A pharmacy owner paid cash kickbacks to a doctor, advanced practice nurses, and an office manager in exchange for medically unnecessary prescriptions for high-reimbursement medications billed to Medicare and Medicaid.
DOJPleaded guiltyJun 24, 2026
Cape May County Psychiatrist Admits to 17 Felony Counts for Unlawful Controlled Substance Prescriptions Linked to Sexual Conduct, Risk of Death, and Serious Bodily Injury
A psychiatrist issued invalid prescriptions for Adderall, Vyvanse, and Xanax to 17 patients outside the usual course of professional practice, with intent to defraud and mislead the dispensing pharmacies and the insurers, government benefits programs, and other third parties who paid for the drugs, sometimes in exchange for sexual activities, images, or videos.
DOJSentencedMay 21, 2026
New Jersey Physical Therapist Sentenced to 12 Months in Prison for Health Care Fraud Scheme Targeting Amtrak
Kim, a licensed physical therapist, allowed her license and business bank accounts to be used to bill Amtrak's health care plan for claims for services that never were provided and were medically unnecessary, in return for a portion of the proceeds.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.